Earlier this year, my first patient of the day (I’ll call him John*) arrived for his dental  visit. I had to double check his chart because I was expecting a 33 year old man, but this person had a full head of gray hair.  Indeed, this patient was a 33 year old.  As he sat down he explained that he was on call for work that week and if his pager went off during his hygiene appointment he would need to phone his team immediately.  He talked about the company he worked for and described the high- stress and demanding environment.  He struck me as someone who worked very hard at his job.

I began the appointment by reviewing his health history for any changes since his last appointment and made a mental note that he had high cholesterol.  Next I assessed his overall oral health and hygiene.  On his X-rays I noticed he had slight bone loss around his teeth, which meant he had Periodontal Disease.  I found that he had generalized inflammation and way too much plaque on his teeth for just having brushed prior to the appointment.  When I asked him to describe his routine at home for cleaning his teeth he told he he brushed twice daily with the freebie toothbrush we gave him every six months (we recommend changing toothbrushes eery three months to keep the bristles effective at cleaning biofilm from the teeth and gumline), and that he rarely flossed.  It occurred to me that his oral hygiene were his work, he would be arriving late every day and missing deadlines.  He certainly wouldn’t be answering his pager when it went off.  I began thinking about ways I could help John improve his oral and overall health.

Inflamed gums are bad for overall heath?

Most of us know that chronic inflammation in the body can be dangerous.  Periodontal Disease (breakdown of the tissue around the tooth) is an inflammatory disorder that affects 75% of the US population and doubles or triples the threat of heart attack or stroke.  According to data on file with the Centers for Disease Control (CDC), heart disease is the #1 cause of death (causes one out of four deaths) and stroke is the fifth- leading cause of death (one out of 20) in the United States.  Fifty percent of heart attacks are triggered by infection in the mouth.  Do I have your attention now?

The good news? You can’t have a heart attack without chronic inflammation! At your dental visits we work hard to help our patients to be their most healthy selves by lowering risk factors.  We can counsel patients on how genetics, conditions or lifestyle components might increase inflammation in the body.  In the dental office our main focus is how to reduce inflammation in the mouth (and therefore in the whole body) by lowering risk factors. 

Risk Factors for periodontal disease

There are many risk factors for periodontal disease, but the main risk factors are genetics, smoking, and diabetes.


We know that certain hereditary factors can increase the risk of periodontal disease.  If you have a family history of periodontal disease it puts you at a higher risk of having it as well.  We know that people of African, Hispanic, and Native American or Native Alaskan descent are at increased risk. 


Smoking weakens the immune system which make it harder to fight off infection of the gums.  This happens because nicotine reduces the vasculature in the mouth.  Once someone has periodontal disease it’s harder for your gums to heal. 


Thickening of the blood vessels is one complication of diabetes. When this happens it slows the delivery of nutrients to the tissues.  The bacteria that live in the mouth feed on sugars, including glucose.  When there are higher levels of glucose in the oral fluids it creates a great set of conditions for these bacteria to thrive. This can set the stage for periodontal disease. 

Managing these risks in the dental office include taking a blood pressure reading, reviewing health history for recent blood sugar level measurements and possible smoking cessation counseling. 

The bulk of what we do during a dental hygiene visit is evaluate the heath of the gum and bone tissue with the measurements we take around the teeth. If we determine there is inflammation of the gum tissue, we can make recommendations on how best to manage and reduce the inflammation. This might include tips on lowering the amount of biofilm on the teeth with brushing (I highly recommend Sonicate toothbrushes for this!) and flossing strategies, special antibacterial rinses, or reducing the amount of time between preventive hygiene visits from every six months to four or even three months.  For people with a lot of build up and inflammation in their mouths, we may even recommend several  treatment visits to dramatically reduce the inflammation.

Putting It All Together

When I saw John six months later I couldn’t believe I was seeing the same person!  His hair was still grey but so much more had changed.  He looked as though he had lost some weight.  I jokingly asked if he was on pager duty again and learned that he was now working at a much lower-stress job.  Upon assessing his oral hygiene and health I discovered much less plaque and inflammation in his mouth.  I shared this observation with him and he told me that he was now using a Sonicare toothbrush.  He was doing a great job of managing his risk factors and moving toward great whole-body health.

We know there are certain things we can do to lower risks for disease and be our most healthy selves.  By making small, attainable changes now you can drastically reduce the amount of inflammation in the mouth and the whole body.  Are you wondering where to begin? Your dental office is a great place to start!

*Patient’s name changed to protect privacy

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